DailyKaizen

One parting message that the team I am part of wanted to make sure I saw came to my in-box, and I was told it’s fine to share.

We are announcing a change to the upgrade schedule [for our Statewide Clinical Information System].  We are now targeting the weekend of October [] instead of Nov [].  Please share this information broadly.  We are making this change based on two factors:

We are ahead of schedule on upgrade work due to focused efforts of our team and our various partners.

In addition to wanting to make you aware of this new date, we want to call out the best possible reason to make this change – our patients.  Efficiencies in our upgrade process and the ability to focus our resources will allow us to ‘give back’ a week of capacity for several cross-functional teams.  This means we will be able to accomplish even more for our patients in 4th quarter 2007.

We have confirmed with clinical and technical partners that this new date is feasible and will work diligently, in partnership with all of your teams, to ensure a successful upgrade a week earlier than planned.

Sincerely,
Emily, Wendy, and Vadim
Managers, Clinical Information System Team

An upgrade of a system of this magnitude is essentially a replacement of the clinical central nervous system. It would be the equivalent of rewiring a small community for electricity and communication, with the requirement that every connection is 100% accurate. In the past, these have taken several months. The system must be upgraded with 100% integrity, and prior to LEAN, we used techniques that got us there, but with multiple handoffs, rechecks, and separation from our members’ experience with the tool. We didn’t know how to do it differently.

Since then, the team has adopted Hoshin Strategy Planning, the creation of multiple work cells, and daily management including the use of copious visual displays. Most importantly, the staff works much closer to our members, in our medical centers, alongside our nurses and physicians.

I asked Emily what the result of this shift of schedule meant in terms of person hours. The number: 1,200. These hours will now be used to continue enhancing our system and adding new features and functions to help serve our patients better, so the savings will multiply across 10,000 staff, who will have a more advanced system sooner.

A few observations of mine:

1. This ROI is different than the type of ROI calculated from a one week rapid process improvement. It’s the culimination of a complete redesign of planning, cross functional, and daily management, over the past 2 years. The team simply works differently now. These are addative.
2. The focus on the impact to patients comes from within. These terrific leaders have been experiencing LEAN for themselves, and with the right environment from their leaders, have done the transition work in a self-directed way.
3. They have the self-efficacy through the use of LEAN philosophy and methodology to do better every time, and they want their colleagues, our members, and the world to know about it. The want to set an example that continuous improvement matters, and it can be done, if people are empowered to do it.

How do I know that #3 is true? Because I asked if it was okay to post the message on this blog, and the answer was, “Or course! That’s why I cc’ed you even though you don’t need this information from an operational point of view :)”

In a field (health information technology) that is expected to see investments upward of $50 billion in the next 2 years, it’s nice to know that there is a way to make this work less complex, more doable, and more in service to patients.

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